Duck William M, Sobel Jeremy, Pruckler Janet M, Song Qunsheng, Swerdlow David, Friedman Cindy, Sulka Alana, Swaminathan Balasubra, Taylor Tom, Hoekstra Mike, Griffin Patricia, Smoot Duane, Peek Rick, Metz David C, Bloom Peter B, Goldschmidt Steven, Parsonnet Julie, Triadafilopoulos George, Perez-Perez Guillermo I, Vakil Nimish, Ernst Peter, Czinn Steve, Dunne Donald, Gold Ben D
Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA.
Emerg Infect Dis. 2004 Jun;10(6):1088-94. doi: 10.3201/eid1006.030744.
Helicobacter pylori is the primary cause of peptic ulcer disease and an etiologic agent in the development of gastric cancer. H. pylori infection is curable with regimens of multiple antimicrobial agents, and antimicrobial resistance is a leading cause of treatment failure. The Helicobacter pylori Antimicrobial Resistance Monitoring Program (HARP) is a prospective, multicenter U.S. network that tracks national incidence rates of H. pylori antimicrobial resistance. Of 347 clinical H. pylori isolates collected from December 1998 through 2002, 101 (29.1%) were resistant to one antimicrobial agent, and 17 (5%) were resistant to two or more antimicrobial agents. Eighty-seven (25.1%) isolates were resistant to metronidazole, 45 (12.9%) to clarithromycin, and 3 (0.9%) to amoxicillin. On multivariate analysis, black race was the only significant risk factor (p < 0.01, hazard ratio 2.04) for infection with a resistant H. pylori strain. Formulating pretreatment screening strategies or providing alternative therapeutic regimens for high-risk populations may be important for future clinical practice.
幽门螺杆菌是消化性溃疡疾病的主要病因，也是胃癌发生的致病因素。幽门螺杆菌感染可用多种抗菌药物方案治愈，而抗菌药物耐药性是治疗失败的主要原因。幽门螺杆菌抗菌药物耐药性监测项目（HARP）是一个前瞻性的美国多中心网络，用于追踪全国幽门螺杆菌抗菌药物耐药率。在1998年12月至2002年期间收集的347株临床幽门螺杆菌分离株中，101株（29.1%）对一种抗菌药物耐药，17株（5%）对两种或更多抗菌药物耐药。87株（25.1%）分离株对甲硝唑耐药，45株（12.9%）对克拉霉素耐药，3株（0.9%）对阿莫西林耐药。多因素分析显示，黑人种族是感染耐药幽门螺杆菌菌株的唯一显著危险因素（p<0.01，风险比2.04）。为高危人群制定预处理筛查策略或提供替代治疗方案可能对未来临床实践很重要。
Zotero 插件